DRUGS & SUPPLEMENTS
Metoprolol is a cardioselective beta1-blocker without intrinsic sympathomimetic activity. This medication has antihypertensive, antianginal and antiarrhythmic effect. Metoprolol decreases automaticity of sinus node, reducing heart rate, slows AV-conduction, decreases myocardial contractility and excitability, reduces cardiac output, reduces myocardial oxygen demand. This drug inhibits the stimulatory effect of catecholamines on the heart during physical and psycho-emotional stress.
Metoprolol causes a hypotensive effect which is stabilized by the end of the second week of a course. With angina Metoprolol reduces the frequency and severity of attacks.
This medicine also normalizes the heart rate during supraventricular tachycardia and atrial fibrillation; when myocardial infarction it contributes to limit the zone of ischemia of the heart muscle and reduces the risk of developing fatal arrhythmias, reduces the risk of recurrence of myocardial infarction. When Metoprolol is used in the medium therapeutic doses it has a less pronounced effect on smooth muscles of the bronchi and peripheral arteries than non-selective beta-blockers.
After oral administration Metoprolol is rapidly and almost completely absorbed from the gastrointestinal tract, Cmax of the active substance in the blood plasma is reached after 1-2 hours. This medication intensively metabolized in the liver to form inactive metabolites. T1/2 of Metoprolol from plasma is 3-4 h and during the course of treatment it does not change. More than 95% of the dose excreted by the kidneys of which only 3% is in unchanged form.
Why is Metoprolol prescribed?
Hypertension, prevention of angina, cardiac arrhythmias, secondary prevention after myocardial infarction, cardiac hyperkinetic syndrome (including in hyperthyroidism, NDCs). Prophylaxis of migraine.
Dosage and administration
For oral administration the average dose of Metoprolol is 100 mg / day in 1-2 reception. If necessary the daily dose gradually increased up to 200 mg. For IV injections a single dose is 2.5 mg, with no effect a re-introduction is possible in 5 minutes.
Maximum daily dose for oral administration is 400 mg, for IV injections a single dose is 15-20 mg.
Metoprolol side effects, adverse reactions
Cardiovascular system: possible bradycardia, hypotension, AV-conduction disturbances, symptoms of heart failure.
Digestive system: at the beginning of therapy may include dry mouth, nausea, vomiting, diarrhea, constipation, and in some cases - liver function abnormalities.
CNS and peripheral nervous system: at the beginning of therapy may be weakness, fatigue, dizziness, headache, muscle cramps, coldness and paresthesia in the extremities; possible reduction in the secretion of tear fluid, conjunctivitis, rhinitis, depression, sleep disturbances, nightmares.
Hemopoietic system: in some cases - thrombocytopenia.
Endocrine: hypoglycemic state in patients with diabetes.
Respiratory system: in predisposed patients may cause symptoms of bronchial obstruction.
Allergic reactions: skin rash, itching.
AV-block II and III degree, sinoatrial block, bradycardia, SSS, hypotension, chronic heart failure IIB-III stages, acute heart failure, cardiogenic shock, metabolic acidosis, pronounced disturbances of peripheral circulation, increased sensitivity to Metoprolol.
Using during pregnancy and breastfeeding
Taking of Metoprolol during pregnancy is only possible if the intended benefits to the mother outweighs the potential risk to the fetus. This medication crosses the placental barrier. In connection with the possible development of a newborn bradycardia, hypotension, hypoglycemia, and respiratory failure, Metoprolol should be abolished for 48-72 hours before the scheduled date of delivery. After delivery it is necessary to ensure strict monitoring of the newborn within 48-72 hours.
Metoprolol in small amounts excreted in breast milk. The using during lactation is not recommended.
With careful use in patients with chronic obstructive airways disease, diabetes, Raynaud's disease and obliterative peripheral arterial disease, pheochromocytoma (to be used in combination with alpha-blockers), pronounced renal and liver functions impairment.
During treatment with Metoprolol a production of lacrimal fluid may decreases, which is important for patients who use contact lenses.
Completion of a long course of treatment with Metoprolol should be gradual (at least 10 days) under the supervision of a physician.
There is not recommended for concurrent use of Metoprolol with MAO inhibitors.
Combined therapy with clonidine should receive the later stop in a few days after discontinuation of Metoprolol, in order to avoid a hypertensive crisis. Simultaneous administration of Metoprolol with hypoglycemic agents require correction of their dosing regimen.
A few days before the anesthesia it is necessary to stop taking this drug or find any anesthesia medication with minimal negative inotropic effects.
Patients whose work requires more attention, the application of Metoprolol outpatients should be addressed only after the evaluation of individual patient response.
Metoprolol drug interactions
Sympatholytics, nifedipine, nitroglycerin, diuretics, hydralazine and other antihypertensive drugs potentiate hypotension.
Antiarrhythmic and anesthetic medications increase the risk of bradycardia, arrhythmia, hypotension.
Digitalis drugs potentiate slowing AV conduction.
Simultaneously intravenous injection of verapamil and diltiazem may cause cardiac arrest.
Beta-adrenoceptor agonists, aminophylline, cocaine, estrogens, indomethacin and other NSAIDs impair antihypertensive effect.
Metoprolol enhances and prolongs the action of anti depolarizing muscle relaxants.
Combination with alcohol leads to mutual reinforcement of inhibitory effects on the CNS.
Allergens increased the risk of severe systemic allergic reactions or anaphylaxis.
Metoprolol edits the effectiveness of insulin and oral antidiabetic drugs and increases the risk of hypoglycemia.
Oral contraceptives, cimetidine, ranitidine, phenothiazines raise the level of this drug in the blood, rifampicin decreases it.
Metoprolol reduces the clearance of lidocaine, the effectiveness of beta 2-agonists (it is necessary to increase the dose of the latter).
This medicine is incompatible with MAO inhibitors of type A.
Metoprolol in case of emergency / overdose
Symptoms: hypotension, acute heart failure, bradycardia, heart block, AV block, cardiogenic shock, bronchospasm, trouble breathing and consciousness, coma, nausea, vomiting, generalized convulsions, cyanosis (manifest in 20 minutes - 2 hours after taking of Metoprolol).
Treatment: gastric lavage, the symptomatic therapy: atropine sulfate injection (IV fast 0.5-2 mg) if bradycardia and a violation of AV conduction; glucagon (1-10 mg IV, then IV infusion 2-2.5 mg / h) and dobutamine in the case of reduction of myocardial contractility; agonists (noradrenaline, adrenaline, etc.) when arterial hypotension; diazepam (IV slowly) to eliminate seizures; beta-agonists inhalation or IV jet injection of aminophylline to relieve broncho spastic reactions; cardioacceleration.
Metoprolol pharmaceutical active ingredients containing related brand and generic drugs:
Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.
Metoprolol available forms, composition, doses:
Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.
Metoprolol destination | category:
Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.
Metoprolol Anatomical Therapeutic Chemical codes:
A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.
Metoprolol pharmaceutical companies:
Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.
Frequently asked QuestionsCan i drive or operate heavy machine after consuming Metoprolol?
Depending on the reaction of the Metoprolol after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Metoprolol not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.Is Metoprolol addictive or habit forming?
Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.
Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.
ReviewsDrugs.com conducted a study on Metoprolol, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Metoprolol consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.
One visitor reported usefulHow is the drug Metoprolol useful in reducing or relieving the symptoms? How useful is it?
According to the survey conducted by the website sDrugs.com, there are variable results and below are the percentages of the users that say the medicine is useful to them and that say it is not helping them much. It is not ideal to continue taking the medication if you feel it is not helping you much. Contact your healthcare provider to check if there is a need to change the medicine or if there is a need to re-evaluate your condition. The usefulness of the medicine may vary from patient to patient, depending on the other diseases he is suffering from and slightly depends on the brand name.
One visitor reported side effectsDid you get side effects while taking the Metoprolol drug, or were there no side effects?
According to the survey conducted by website sDrugs.com users, the below-mentioned percentages indicate the number of people experiencing the side effects and the number of people not experiencing the side effects when taking Metoprolol medicine. Every drug produces minimal side effects, and they are negligible most times, when compared to the desired effect [use] of the medicine. Side effects depend on the dose you are taking, any drug interactions that happen when you are on other medications, if the patient is sensitive, and other associated conditions. If you cannot tolerate the side effects, consult your doctor immediately, so he can either adjust the dose or change the medication.
One visitor reported frequency of useHow often in a day do you take the medicine?
Are you taking the Metoprolol drug as prescribed by the doctor?
Few medications can be taken Once in a day more than prescribed when the doctor's advice mentions the medicine can be taken according to frequency or severity of symptoms. Most times, be very careful and clear about the number of times you are taking the medication. The report of sDrugs.com website users about the frequency of taking the drug Metoprolol is mentioned below.
One visitor reported dosesWhat is the dose of Metoprolol drug you are taking?
According to the survey conducted among sDrugs.com website users, the maximum number of people are using the following dose 11-50mg. Few medications come in only one or two doses. Few are specific for adult dose and child dose. The dose of the medicine given to the patient depends on the severity of the symptom/disease. There can be dose adjustments made by the doctor, based on the progression of the disease. Follow-up is important.
One visitor reported time for resultsWhat is the time duration Metoprolol drug must be taken for it to be effective or for it to reduce the symptoms?
Most chronic conditions need at least some time so the dose and the drug action gets adjusted to the body to get the desired effect. The stastistics say sDrugs.com website users needed 1 month to notice the result from using Metoprolol drug. The time needed to show improvement in health condition after using the medicine Metoprolol need not be same for all the users. It varies based on other factors.
One visitor reported age
The information was verified by Dr. Arunabha Ray, MD Pharmacology